Abstracts

Over the past decade, the use of the ketogenic diet internationally has increased dramatically. Our objective was to examine some of the worldwide issues in the administration of the ketogenic diet as well as gather academic center information for referrals and collaboration. Using the Internet, email requests for information about international ketogenic diet centers were made over a three-month period. Assistance was also obtained from the Child Neurology Society and International League Against Epilepsy. Questions included patient enrollment (total and annually), year the diet was first offered, unique cultural and religious issues in their country, community opinion, and research interests. Successful communication was made with 56 academic centers in 35 countries outside the United States. Twelve (34%) countries provided information from multiple centers. Sixteen centers also provided a recipe for a ketogenic meal using native foods. The median duration offering the diet was 8 years (range 1-31). The average number of patients enrolled to date was 71.6 per country, with 5.4 started annually. Common difficulties included avoiding rice intake, tolerating high fat to protein and carbohydrate ratios (e.g. 4:1), and handling the growing interest from large population bases with limited resources. However, cultural and religious issues were generally not limiting, physician and patient acceptance is high, and most foods were similar. Centers often had great pride in their programs and international collaborative groups are forming rapidly. Despite occasional difficulties, the ketogenic diet is gaining momentum abroad.